Screening Won’t Cut Sudden Heart Death Risks

Screening athletes for risk factors tied to sudden cardiac death won’t likely reduce the number of cases, new research suggests.

The study, presented at a meeting of the American College of Cardiology, indicated only about one in one million cases of rare SCD linked to cardiovascular conditions could be reliably detected by pre-participation screening.

"Screening initiatives for high school-aged athletes has the potential to impact 10-15 million young adults in the U.S.," said lead researcher Barry J. Maron, M.D., director of the Hypertrophic Cardiomyopathy Center at the Minneapolis Heart Institute Foundation in Minneapolis.

"This is a controversial issue because some are suggesting that all young competitive athletes should be screened with a 12-lead ECG screening, which would be a massive and costly undertaking. Also, we do not have any evidence to show whether this is clinically necessary."

Sudden death in young athletes due to cardiovascular disease is rare, but has raised serious health concerns about the potential risks from sports competition for some youngsters.

Currently, athletes are assessed through a physical exam and reviewing the individual's clinical history.

Dr. Maron and his colleagues tracked the records of the U.S. National Registry of Sudden Death in Athletes over a 26-year period (1986-2011) to identify cases tied to cardiovascular problems among athletes in Minnesota. There were more than 4.44 million sports participations, including 1,930,504 individual participants among 24 sports.

The results identified 13 incidence of sudden deaths in high school student-athletes related to physical exertion during competition (seven) or at practice (six). Sudden deaths occurred in 1 out of 150,000 participants.

Autopsies identified underlying cardiac causes in seven of the 13 deaths. In only four athletes could those cardiovascular diseases have been reliably detected by history, physical exam, or 12-lead ECG, which is the equivalent of one in one million participants.

"This very low event rate does not warrant changing the current national screening strategy, especially because only one-third of the deaths would have been detectable through additional screening," said Dr. Maron. "These findings demonstrate that these tragic events are rare. In addition to these data, no evidence in the medical literature has shown that ECGs reduce mortality in a broad-based screening effort."